老年人股骨粗隆部骨折的手术治疗策略

Operative treatment tactics for femoral trochanteric fractures in the elderly

目的探讨老年人股骨粗隆部骨折适宜的手术方式。方法对184例老年股骨粗隆部骨折采用4种不同手术方式,对其疗效进行分析讨论。结果对182例随访9月至3年,平均15月。无严重的卧床并发症发生,参照张铁良等疗效评定标准,优良率为85.7%,135°动力髋加压螺钉治疗组有8例不稳定骨折效果不佳。结论老年股骨粗隆部骨折的手术方法应根据内固定能满足维持骨愈合和提供骨折部位所必须的稳定的要求来选择,同时应考虑到老年患者的身体状况。

Objective To discuss the suitable operative method for femoral trochanteric fractures in the elderly. Methods A retrospective analysis of 184 elderly cases of femoral trochanteric fractures in four different operative ways was conducted. Results Follow-up period ranged from 9 to 36 months （average 15 months）in 182 case. Of them, no serious laid-in-bed complications occurred, and 85.7% achieved satisfactory results according to Zhang tieliang＇s evaluating standard, 8 unstable cases in 135 DHS group healed with worse result. Conclusions The internal fixator must meet the needs of maintaining bone-healing and keeping fracture position stable when operation was made about femoral trochanteric fractures in the elderly, meanwhile the general conditions of the aged must be paid attention to.